Navigating Audiology Proposals: What's The Difference Between the Legislative Initiatives from AAA, ADA and ASHA?
Written by Lisa Reedy, a third year AuD student at the Northeast Ohio AuD Consortium, and a member of the SAA Advocacy Committee
Studying for your AuD is a challenging experience. With all of the information being thrown at you daily, it may be tempting to say “I’ll think about these legislative issues later, I’m too busy right now.” But we must recognize that today’s legislative issues are shaping the environments in which we’ll be practicing. We have to be involved now if we want a say in how our future unfolds. So what audiology initiatives are out there right now?
The American Speech-Language-Hearing Association (ASHA) has shepherded bill H.R. 2330. This legislation seeks to change regulations within the Social Security Act so that audiologists, who currently are reimbursed by Medicare only for diagnostic services, can bill and be reimbursed for treatment services as well. In order to obtain this new reimbursement, audiologists would create a treatment plan for each patient and submit it to the patient’s physician, nurse practitioner, physician assistant, or clinical nurse specialist. One of these professionals must then sign off on it for treatment to begin. This bill will not change Medicare’s policy of excluding hearing aid coverage; it applies only to treatment such as aural and vestibular rehabilitation, and Medicare patients would still be required to obtain a physician order prior to visiting an audiologist.
The Academy of Doctors of Audiology (ADA) has proposed the 18x18 Initiative which seeks: Limited License Physician (LLP) status for audiologists under Medicare, Direct Access to audiologists for Medicare patients, and a comprehensive audiology Medicare benefit. The comprehensive Medicare benefit means that audiologists would be able to bill and be reimbursed for treatment as well as diagnostics under Medicare. This is a similar goal to ASHA’s without the requirement of physician approval of treatment plans because audiologists would have LLP status. LLP status moves audiologists from strictly a diagnostic profession to an evaluation and management profession in the eyes of Medicare. It doesn’t change what audiologists can do, it only changes how Medicare views audiologists for purposes of reimbursement. The Direct Access piece is similar to AAA’s signature legislation which is discussed below.
The American Academy of Audiology (AAA) has legislation to allow Direct Access to audiology services for Medicare patients. Under the current Medicare guidelines, patients must obtain an order from their physician before seeing an audiologist for diagnostic services in order for that audiologist to be reimbursed by Medicare. Direct Access means that these patients no longer need an order and would be able to see an audiologist directly. The elimination of an order means patients would not be required to have unnecessary appointments with their physicians and would eliminate additional costs (time and money) incurred by Medicare beneficiaries and the Medicare system. Direct Access breaks down barriers between patients and audiologists.
Why does AAA support Direct Access? Consultants and policy experts believe that legislation with a single focus, like Direct Access, is the best route. Legislation that has multiple goals can be difficult to pass in the current Congressional climate. AAA has honed this legislation over time and believes this is the best first step. It does not achieve all of audiology’s goals, but by gaining Direct Access first, AAA believes other goals like LLP status and gaining reimbursement for treatment will be easier to achieve in the future because audiology will have proven its value. AAA requested that Dobson | DaVanzo, a health care consulting firm, conduct a study on the cost of Direct Access. It showed that Direct Access would actually SAVE Medicare money which is a big bonus in the eyes of the government at a time when budget deficits and debt ceilings are huge concerns. Neither of the other audiology-focused initiatives have a study backing them showing cost implications for the proposed policy changes.
More information about ASHA and ADA’s initiatives can be found on their respective organizational websites. More information about AAA’s Direct Access can be found here. Regardless of which legislation you support, it is important that you voice your opinion. If you believe in something, you must make it known. You can visit AAA’s Legislative Action Center to find your elected officials and ways to contact them. There are emails already written that you can send, or you can edit them, or even write your own! We are the future of our profession and we have the opportunity to help shape it. Don’t sit on the sidelines! Take action!